Paul Sax Profile picture
Nov 29 25 tweets 13 min read
Way back in April of this year, I received a kind invitation from @PaulPottingerMD to speak about Twitter at this year’s IDWeek.
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Sounded like fun--plus I could learn from @KrutikaKuppalli and @Payal_Patel, so I readily accepted ...

... little imagining that shortly after IDWeek, this site would be embroiled in various controversies -- about which many others have already weighed in wisely!
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But here's a condensed version of the talk, which explains why I'm sticking around (at least for now).

Let’s start with the (dreaded) “Learning Objectives”, which I’ve tried to enliven with pic of my pup.
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People who don’t use Twitter might be thinking along the same lines as Dr. Milton Packer. medpagetoday.com/opinion/revolu…
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He makes several valid points, which I further summarize here.
(Stay tuned, the "Rules" come at the end of this thread.)
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I was in this camp too for quite some time! Here’s my personal history, am sure many can share something similar.

It all began with 2009 @nytimes column by their then "State of the ART" tech writer @Pogue. nytimes.com/2009/02/12/tec…
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Here’s what changed -- three things in particular.

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So why use Twitter? Am sure there are other reasons, but here are mine.

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Those on other social media platforms (notably FB and instagram) might wonder how this differs.

Note that people are vastly more likely to use Twitter for professional reasons. (I got this slide from either @CarlosdelRio7 or @GermHunterMD, thank you for sharing!)
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If you're reading this for the first time, and don't have an account, here’s how to get started.
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My profile, plus one of my co-presenter’s at this IDWeek session.

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Can't resist sharing @jrarribas' profile, which makes me laugh every time I see it! 😂
(By the way, he assures me all the acronyms are real. Es verdad!)
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Now, onto the structure of an IDTweet, using a splendid example from @richdavisphd.
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Certainly you might still have questions or concerns. I address some of them here.

Note I prefer not to have the app on my phone (too distracting), but ymmv.

... and #5, by the way, is a joke.
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Read or publish something of interest, and want to share it?

Here's a paper published in @CIDJournal by @DrJRMarcelin et al with an important equity message.
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Keeping up with the literature is greatly facilitated by this site, especially with smart and prolific posters such as @ABsteward.

FYI, had never even *heard* of cefepime/enmetazobactam before this post. Hey -- you can learn a lot here!
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Sometimes authors of important studies start a dialogue with readers, answering their queries.

So much better (and faster) than traditional “Letters to the Editor” in journals, which can take weeks or even months to come out.
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One of the most useful teaching strategies is to put together an educational Twitter thread of linked posts, or “tweetorial” -- and @tony_breu is a master.

Even the @NEJM agrees!
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Here’s a recent ID-related gem, which delves into that pesky 100,000 number for "true" UTI.

Where did that come from?

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@GermHunterMD posted this extraordinary thread that both educates and muses -- at least if you're an ID geek like us.

BTW, if you’re about to take your ID boards and have limited time, read this thread!
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For me, keeping up with the latest science on Covid19 would not have been possible without smart and generous scientists sharing their expertise, such as @DrJLi and @EricTopol, among *many* others.

The field simply moves too fast. Image
So if you've figured out a good way to teach a complex subject, sharing it via a Tweetorial is just the thing!

Here @Darcy_ID_doc offers this stellar review of HIV resistance testing.
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A brief digression to make sure we’re in compliance with accreditation guidelines ... 🐶
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Now, how to stay out of trouble -- because that's a real problem here, and one best avoided.

For that, I turn repeatedly to @waitwait's very funny host @petersagal, and his Rules of Twitter. True wisdom -- for here and for life!
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Wrapping up with some take-homes, mostly focusing on the positives -- which on balance still outweigh the negatives, at least for me.

As @Pogue wrote way back in 2009, "DON’T KNOCK IT TILL YOU’VE TRIED IT!"
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More from @PaulSaxMD

Feb 5
Since talks on Covid get out of date as soon as you click "save", might as well post the talk given this week at @harvardmed Medical Grand Rounds, along with by @k_stephensonMD @SanjatKanjilal and Dr. Ruanne Barnabas
Here's the topic:
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Let’s start with the controversy over disease severity, subject that appears both to excite and annoy people (for reasons that I hope to explain)

Also, a reminder that Omicron was a (very unwelcome) 2022 holiday "gift" -- will always link it to Thanksgiving!

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These early anecdotal reports came from South Africa that the disease was milder with Omicron.
True? Or just wishful thinking?
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Read 32 tweets
Dec 31, 2021
We HIV/ID clinicians have been dealing with these for years.

Yes it's a long list, but five days will seem relatively manageable compared with chronic ritonavir administration, especially since the effect is quick on/quick off.

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... or should I say *relatively* quick on/off, right @ErinMcCreary? doi.org/10.1093/jac/dk…

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Some drugs on this list (e.g. statins) can be held for 5 days. Others (calcineurin inhibitors) dose-reduced and monitored. Some aren't used very often any more. There are alternatives that can be temporarily substituted in some pts (e.g. lorazepam for clonazepam).

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Read 5 tweets
Nov 21, 2021
Yesterday I posted a long thread on the extraordinary progress we’ve made in HIV care and research since report of the first cases 40 years ago. Now for Part 2!

(I stopped at around year 20. Here’s the link to Part 1, in case you want to catch up )
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When we left off, we'd experienced the thrill of effective combination ART. Our 2 major news magazines featured advances in HIV on their covers! One of these guys was a basketball star, the other an HIV researcher -- see if you can guess which one is which

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But the excitement of having effective ART was tempered by the realization that these treatments had major issues, including side effects, high pill burdens, and low resistance barriers. The "when to start?" question became a central part of HIV care

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Read 21 tweets
Nov 20, 2021
The "History of HIV" talk I gave last week actually has this title, which I don't think is an overstatement. Posting it now with gratitude, just in time for Thanksgiving (my favorite holiday -- the gratitude and family part).

(Part 1 thread)
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Must start with this 1981 @CDCMMWR report of 5 cases of PCP in Los Angeles. Have already commented on the surprising page 2 placement. There's a story behind it, right @deborahcottonmd? (Later moved to Page 1 on reprints.) Note “blue diazo” slide style

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During my first year of med school, we had one lecture on AIDS, with putative causes. Not an auspicious start.
(Yes, 1983. I'm old.)

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Read 15 tweets

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